Are there differences between a real C0-C1 mobilization and a sham technique in function and pressure pain threshold in patients with chronic neck pain and upper cervical restriction? A randomised controlled clinical trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(5):12 J Back Musculoskelet Rehabil. 2023;36(1): 61-70.What this means for my practice?
The results of this study suggest that dorsal gliding mobilization of the C0-C1 region can provide immediate improvements in upper cervical mobility, with potential pain relief benefits as well for patients with chronic neck pain and upper cervical restriction. This study was limited by the application of only 1 treatment session and immediate evaluation, which limits the assessment of its long term benefit or its benefit in different doses (more sessions, longer sessions). There was also no measurement of pain through a Visual Analog Scale or Pain Rating Scale, which could have provided more information on its clinical benefit. Future studies with longer follow up, more patients, and a wider range of outcomes are necessary.
Study Summary
Twenty-eight patients with chronic neck pain and upper cervical restriction were randomized to receive a single session of C0-C1 dorsal gliding manual therapy (n=14) or a sham treatment (n=14). The primary outcome of interest was the flexion-rotation test variable. Secondary outcomes included upper flexion-extension mobility, pain pressure threshold, and deep flexor muscle activation, measured immediately post-treatment. The active dorsal gliding therapy group demonstrated significantly better improvement in the flexion-rotation test, upper cervical range of motion in extension, and right splenius pressure pain threshold compared to the sham group.
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